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Drug interactions: theory versus practice.

J W Griffin, J R May, J T DiPiro

    The American Journal of Medicine
    |November 19, 1984
    PubMed
    Summary
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    Cimetidine drug interactions increase toxicity risks. Ranitidine is a safer alternative for patients on P-450 metabolized medications, reducing potential drug toxicity and healthcare costs.

    Area of Science:

    • Pharmacology
    • Drug Metabolism
    • Clinical Pharmacy

    Background:

    • Cimetidine inhibits P-450 oxidative metabolism, leading to drug interactions and toxicity.
    • H2-receptor antagonists can alter gastric secretion, affecting drug absorption.

    Purpose of the Study:

    • To assess the incidence of concomitant cimetidine and interacting drug use in inpatients.
    • To evaluate the clinical significance of cimetidine-induced drug interactions on toxicity.

    Main Methods:

    • One-year survey of inpatient prescribing practices.
    • Retrospective chart review of patients receiving cimetidine with theophylline or phenytoin.

    Main Results:

    • 32.6% of inpatients received cimetidine with interacting drugs.

    Related Experiment Videos

  • Statistically significant increases in toxic theophylline levels observed.
  • A trend towards increased toxicity rates in phenytoin-cimetidine treated patients.

    • Conclusions:

    • Cimetidine use with P-450 metabolized drugs increases toxicity risk.
    • Ranitidine is a preferred alternative to cimetidine in such cases.
    • Concurrent use necessitates frequent drug level monitoring, increasing patient costs.